Stabilność psychiatryczna w krótkim okresie po rozpoczęciu leczenia brivaracetamem u pacjentów z epilepsją: badanie obserwacyjne prospektywne
Short-Term psychiatric stability after brivaracetam initiation in patients with Epilepsy: A prospective Observational study
W skrócie
Badanie sprawdzało czy lek brivaracetam wpływa na zmianę nastroju, agresywności i senności u dorosłych pacjentów z epilepsją. U większości pacjentów, którzy kontynuowali przyjmowanie tego leku przez 8-12 tygodni, nie zaobserwowano pogorszenia się objawów depresji, agresji czy senności. Wyniki pokazują, że brivaracetam ma neutralny wpływ na samopoczucie psychiczne, choć u dwóch pacjentów leczenie przerwano z powodu drażliwości.
Oryginalny abstract (angielski)
OBJECTIVE: Behavioral and psychiatric adverse effects are important considerations when selecting antiseizure medications for patients with epilepsy. Levetiracetam (LEV) may be associated with irritability and aggression, whereas brivaracetam (BRV) has been suggested to have a more favorable psychiatric tolerability profile. However, prospective evidence using validated psychiatric rating scales in routine clinical practice remains limited. This study evaluated changes in aggression, depressive symptoms, and daytime sleepiness after BRV initiation. METHODS: Adult patients with epilepsy who initiated BRV at two outpatient centers completed standardized self-report questionnaires at baseline and again approximately 8-12 weeks later. Aggression, depressive symptoms, and daytime sleepiness were assessed using the Buss-Perry Aggression Questionnaire (BAQ), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and a modified seven-item Epworth Sleepiness Scale (ESS), respectively. Reported seizure counts were assessed as exploratory secondary outcomes. RESULTS: Of 73 adult patients who initiated BRV, 63 completed both baseline and follow-up assessments. Among treatment completers, BAQ total and subscale scores, NDDI-E scores, and modified ESS scores showed no significant changes over time. Regression analysis did not identify predictors of change in BAQ total scores. Two patients discontinued BRV before follow-up because of irritability. Reported seizure counts decreased in a secondary exploratory analysis. CONCLUSION: Among treatment completers, BRV initiation was not associated with significant group-level worsening of aggression, depressive symptoms, or daytime sleepiness. These findings support short-term psychiatric stability among patients who continued BRV treatment in routine clinical practice. However, early discontinuation due to irritability in two patients indicates the need for monitoring behavioral adverse effects.